Appendix A

Structural Works, CERCA Viento, Alveo Project

Inspection and Test Plan

Structural Works (Rectification of Concrete Defects)

A 04/05/2019 ISIAH PAUL R. ALVAREZ KRISTY MAE PAQUITA

- MDC Project Supervisor QA Engineer / Architect

Rev. Date Prepared Checked Description

Document Review
Activity Company Name Title Signature Date

Reviewed by MDC TSD Officer

Reviewed by MDC Project In-Charge

Reviewed by MDC QA Supervisor

Approved by MDC Project Manager/PIC

Item Description Inspection or Testing By Whom Frequencies Acceptance Criteria Test Methods QA Records

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Appendix A

Structural Works, CERCA Viento, Alveo Project

Inspection and Test Plan
(/QC) (QC)
I. Work Activity Submittal
Pre-Construction
1 Pre-Construction – Plans / RFA’s
1.1 RFA for Materials Review RFA for Materials MDC/Field 1 set of RFA Approved Material N/A Check if RFA’s Approved RFA’s
Engineer and RFA are approved

2 Pre-Construction – Method Statement

2.1 Method Statement Prepare Method Statement Field Engineer Per scope of work Approved Method N/A Review Approved Method
(Methodology) Statement Statement
3
Pre-Construction –Materials
3.1 SikaGrout – 215 (Non- Review Manufacturer’s Certificate Supplier Bond Strength Test – Contract Specs. COE CRD – C – 621 Check Product Data
Shrink Grout) MDC/Consultant 3 Sample Test – 7day, Approved Method Non Shrink Grout
14days, 28days Statement
ACI 347 Surface
Allowable Tolerances
3.2 Lanko 113 (Surface Review Manufacturer’s Certificate Supplier Bond Strength Test – Contract Specs. COE CRD – C – 621 Check Product Data
Preparation) MDC/Consultant 3 Sample Test – 7day, Approved Method Non Shrink Grout
14days, 28days Statement
ACI 347 Surface
Compressive Strength Allowable Tolerances
Test – 3 Sample Test
– 7day, 14days,
28days
3.3 Lanko 101 (Surface Review Manufacturer’s Certificate Supplier Bond Strength Test – Contract Specs. COE CRD – C – 621 Check Product Data
Preparation) MDC/Consultant 3 Sample Test – 7day, Approved Method Non Shrink Grout
14days, 28days Statement
ACI 347 Surface
Compressive Strength Allowable Tolerances
Test – 3 Sample Test
– 7day, 14days,
28days
3.3 RC CHEM Epoxy Z-200 (All Review Manufacturer’s Certificate Supplier Bond Strength Test – Contract Specs. ASTM D 1652 Check Product Data
Purpose Bonding Epoxy) MDC/Consultant 1 Sample Test – 7day, Approved Method
Statement
Compressive Strength
Test – 1 Sample Test
– 7day

Flexural Strength Test

– 1 Sample Test –
7day

Tensile Strength Test

– 1 Sample Test –

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Appendix A

Structural Works, CERCA Viento, Alveo Project

Inspection and Test Plan
7day
3.4 RC CHEM Epoxy Z-400 Review Manufacturer’s Certificate Supplier Bond Strength Test – Contract Specs. ASTM D 1652 Check Product Data
(Grouting and Injection MDC/Consultant 1 Sample Test – 7day, Approved Method
Epoxy) Statement
Compressive Strength
Test – 1 Sample Test
– 7day

Flexural Strength Test

– 1 Sample Test –
7day

Tensile Strength Test

– 1 Sample Test –
7day

By Whom Frequencies Acceptance

Item Description Inspection or Testing Test Methods QA Records
(/QC) (QC) Criteria
II. Work In-Progress
1 Construction – General - Layout of Structural Elements
1.1 Survey Survey Request FE/MDC Per Element - - Check Survey Request/
Line, Grade and Layout Excavation Checklist
Survey Report Survey Team Per Element Survey Data

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Appendix A

Structural Works, CERCA Viento, Alveo Project

Inspection and Test Plan

By Whom Frequencies Acceptance

Item Description Inspection or Testing Test Methods QA Records
(/QC) (QC) Criteria
III. Work Activity Completion

1 Post-Construction
1.1 Work Inspection Request Visual FE/MDC Per Work Activity / Scope - - Hold Point Work Requests

1.2
1.3
1.4 As-Built Survey Survey Report Survey Team Per Work Activity / Scope Per drawing - - Report

1.5

1.6 Punchlisting Overall Quality of Work FE/MDC/QA All Completed System Per requirements / Inspect Punchlist Form (MDC and
Based on plans and Engineer Approved APMC)
Technical Specs Methodology /
Technical Specs
1.7 Hand Over Completion of Work FE/MDC Per Scope / Activity Completed Works Review Handover Form
Activity
1.8 Documentation Filing of Records FE/Docs Controller Per activity Per Requirement Review Records
Prepared by: Approved by:

Isiah Paul Alvarez Alfonso Carlo M. Pizarro

MDC – P. Supervisor MDC - PIC

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